Bariatric surgery article
Paper type: Health and fitness,
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Unhealthy weight affects much more than one-third of U. H. adults (Centers for Disease Control and Prevention). Unhealthy weight is defined by World Health Corporation as an individual that has a BODY MASS INDEX greater than 35. Obesity by itself can impede a person’s everyday living lifestyle. On the other hand along with obesity come several co-morbidities that can influence a person’s health and lifestyle in a negative way. Obesity related conditions include heart disease, stroke, type two diabetes, hypertension, stop snoring, and bronchial asthma. One option solution pertaining to obese patients’ to improve their particular quality of life can be bariatric surgery.
Bariatric surgery is the only weight loss method proven to achieve lasting, long term results (Kaser & Kukla., 2009, p. 3).
Bariatric surgery works on two principals: restriction and malabsorption (Kaser & Kukla. 2009 p. 3). Per Kaser & Kukla on page 3 of the Online Journal of Issues in Nursing there are 3 types of bariatric surgery available; One is the least invasive, uses an adjustable gastric band to adjust the size of the stomach and is reversible.
The second one uses a sleeve that reduces the stomach and also eliminates some of the ghrelin hormone that is used to stimulate appetite. The last procedure divides the stomach to create 15-30 ml pouch and is connected directly to the small intestine. This procedure is the most common weight lost surgery performed in the US and makes up 80% of all bariatric procedures (Kaser & Kukla. 2009 p. 3). This paper will discuss the nurse’s role during the pre-op, intra-op, and post-op phases of bariatric surgery, including some of the complications that may arise, proper nursing interventions, and relevant nursing diagnoses with every phase of the patient’s procedure. Nurses play a large role in caring for patients who have bariatric surgery.
The nurses’ role starts in the evaluation phase during office visits and all the way through to post-operative careincluding follow up visits. During the preoperative phase the nurse works with the health care team of “¦surgeons, dietitians, psychologist, bariatricians¦during patient evaluation to help reinforce key points for successful surgical weight loss¦ (Kaser & Kukla, 2009, p. 2) and provide on-going education regarding the patient’s current diet and future diet, activity, and the available surgical procedure options. The nurse ensures that the surgery is appropriate by ensuring the person has “¦.a BMI >40 or BMI >35 along with comorbid conditions, just like cardiovascular disease, stop snoring, uncontrolled type two diabetes, and/or physical problems interfering with overall performance of daily activities (Kaser & Kukla, 2009, s. 2).
In the obese sufferer, “minimizing risk factors is usually directly linked to patients’ examination in the preoperative period. Crucial physiopathologic adjustments occur in the cardiovascular, respiratory and stomach systems (Tanaka, D., & Peniche, A. 2009 s. 619). Breastfeeding diagnoses that needs to be considered intended for preoperative bariatric surgery would be knowledge shortfall, anxiety, dietary imbalance (more than the body system requirements), exposure to possible impaired epidermis integrity, and ineffective inhaling and exhaling pattern associated with morbid obesity and/or comorbidities (Drake, McAuliffe. 2012 s. 6). “The key to a powerful and safe bariatric patient managing program is usually to be prepared prior to the admission (Muir & Archer-Heese, 2009, pg. 2). “Studies have demonstrated that over 50 percent of bariatric-surgery patients possess a concurrent diagnosis of anxiety, depression, or possibly a psychological disorder (Kaser & Kukla, 2009, p. 6).
“Ensure the person understands the lifestyle changes which might be required for a safe, successful, postoperative course together with a lifelong commitment to modified eating patterns, vitamin supplements, and standard monitoring by their healthcare provider (Kaser & Kukla, 2009, p. 2). The registered nurse can provide treatment during the intraoperative phase by causing sure the operating area is sufficient in dimensions, the equipment can accommodate obese patient size by having stretchers with a you, 000 pound capacity and extra width, bariatric bed with expandable deck with electric power assisted for moving, and a pre-installed scale (Muir & Kukla 2009 s. 4). Many of the most frequently used nursing diagnoses for the patient during bariatric surgery will be risk for ineffective airway, and risk for hypothermia. Bariatric surgery patients are especially susceptible to a great ineffective throat during surgical procedure becausethese people “¦tend to acquire decreased lung expansion due to an elevated diaphragm as well as significantly less compliant lung area and upper body walls¦layers of fat for the chest wall and stomach along with an elevated diaphragm increase the operate of breathing (Drake, D. J., & Lopez, C. C., 2005, p. 5). It is the nurse’s job to closely keep an eye on the patient’s work of breathing during surgery to assure no complications arise.
Along with the post-op stage of bariatric surgery arrive an array of breastfeeding interventions and far needed education for the person. While the affected person is totally aware of the life-style changes they need to make ahead of surgery is definitely even performed, it is also available to a level where they have to act on these changes with full confidence and tenaciousness if the method is to be a life-long accomplishment. Some common nursing diagnostic category for post-op bariatric surgical treatment include risk for nutritional disproportion (less than body requirements), risk for infection, risk for shaky blood glucose level, risk for reduced tissue ethics, mainly the tissue lining the tummy, and preparedness for improved self-health management. Diet has to be completely improved following medical procedures. Bariatric medical procedures patients receive a “strict diet post-operatively that regulates the persistence, volume, healthy and chemical makeup of foods¦nurses need to understand diet plan recommendations for the immediate postoperative period and assist the patient in understanding the importance of adherence (Drake, D. J., & Lopez, C. C., 2005, l. 6).
Diet plan compliance is very important, but there are other extremely important interventions to consider after bariatric surgery. Three important facets of nursing treatment include pain management, wound and skin care, and venous thromboembolism prophylaxis. “Pulmonary bar is the second most common cause of mortality in bariatric-surgery patients (Kaser & Kukla, 2009, p. 4). DVT’s and VTE’s could be easily averted when the proper nursing interventions are used. “¦turning, coughing, and meditation (incentive spirometry) are the tried and true nursing affluence for pulmonary care inside the postoperative surgical patient (Kaser & Kukla, 2009, l. 5). As with wound attention, patients should be careful with coughing or perhaps possible nausea leading to throwing up due to chances of dehiscence with the surgical cut sites.
Proper nursing maintain wounds needs to be practiced, which includes “observing pertaining to signs of illness, and keeping the dressings expending dry¦treatment of nausea and prevention of vomiting are crucial during the postoperative phase (Kaser& Kukla, 2009, p. 4). In conclusion the nurses’ part goes beyond rendering direct nursing jobs care in the preoperative, intraoperative, and postoperative phases. To get nurses’ to reach your goals in looking after bariatric patients they need to look at their own personal attitudes and biases. Make sure they are treating the consumer, not making assumption on the person’s figure, intelligence, or health status based off their fat, be respectful and do not fault. Nurses need to treat the psychosocial aspect of the specific demands of the bariatric patient by providing them ideal feedback and encourage beneficial behaviors. All of these will make to get a successful end result for the person. Bariatric surgical procedure is a health promoting and life-sustaining treatment (Drake, M. J., & Lopez, C. C., 2006, p. 7).
Centers intended for Disease Control and Avoidance. Overweight and Obesity; Gathered from: http://www.cdc.gov/obesity/data/adult.html Drake, M. J., & Lopez, C. C. (2005). Postoperative nursing care of patients after bariatric surgery. Perspectives, 6, 1-5. Grindel, M., & Grindel, C. (2006). Nursing care of the person having bariatric medical procedures. MEDSURG Medical, 15(3), 129-146. Kaser, D., Kukla, A., (January thirty-one, 2009). “Weight-Loss Surgery. OJIN: The Online Diary of Concerns in Nursing jobs Vol. 13, No . you, Manuscript some. Retrieved by: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No1Jan09/Weight-Loss-Surgery.html Tanaka, D., & Peniche, A. (2009). Perioperative care for abnormal obese individual undergoing bariatric surgery: issues for nurses [Portuguese]. Acta Paulista De Enfermagem, 22(5), 618-623.